目的 探讨银杏蜜环口服溶液联合注射用阿替普酶治疗急性脑梗死的临床疗效。方法 选取2017年1月-2019年1月天津市宁河区医院的96例急性脑梗死患者研究对象，使用随机数字表法将患者分为对照组和治疗组，每组各48例。对照组患者给予注射用阿替普酶，0.9 mg/kg，其中10%静脉推注，剩余的90%在1 h内静脉滴注。治疗组在对照组治疗的基础上口服银杏蜜环口服溶液，10 mL/次，3次/d。两组患者治疗14 d。观察两组的临床疗效，比较两组的美国国立卫生院神经功能缺损评分（NIHSS）评分、欧洲生活质量量表（EuroQOL）评分、血清神经功能相关因子、血液流变学指标、血管内皮功能指标。结果 治疗后，对照组和治疗组的总有效率分别为77.08%、91.67%，两组比较差异有统计学意义（P<0.05）。治疗后，两组的NIHSS和EuroQOL评分显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的NIHSS和EuroQOL评分均明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）、同型半胱氨酸（Hcy）、S100β蛋白（S100β）水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组血清NSE、Hcy、S100β水平均明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组的血浆黏度、全血高切黏度、全血低切黏度均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的血浆黏度、全血高切黏度、全血低切黏度均明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血清内皮素-1（ET-1）水平明显降低，血清一氧化氮（NO）水平明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组血清ET-1水平明显低于对照组，血清NO水平明显高于对照组，两组比较差异有统计学意义（P<0.05）。结论 银杏蜜环口服溶液联合注射用阿替普酶治疗急性脑梗死具有较好的临床疗效，能够促进神经功能的恢复，改善血液流变学和血管内皮功能，提高患者的生活质量，具有一定的临床推广应用价值。

Objective To explore the clinical efficacy of Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (96 cases) with acute cerebral infarction in Tianjin Ninghe Hospital from January 2017 to January 2019 were divided into control and treatment groups according to random number table method, and each group had 48 cases. Patients in the control group were given Alteplase for injection, 0.9 mg/kg, 10% of this dose were injected intravenously, and the remaining 90% were intravenously injected in 1 h. Patients in the treatment group were po administered with Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, EuroQOL scores, serum nerve functional related factors, hemorheology indexes, and vascular endothelial function indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.08% and 91.67%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores and EuroQOL scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NSE, Hcy, and S100β in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum nerve functional related factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, plasma viscosity, whole blood high shear viscosity, and whole blood low shear viscosity in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the hemorheology indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of ET-1 in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the vascular endothelial function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution combined with Alteplase for injection has clinical curative effect in treatment of acute cerebral infarction, can promote the recovery of nerve function, improve hemorheology and vascular endothelial function, and improve the quality of life of patients, which has a certain clinical application value.

R971